Guiding patients through complexity Modern medical generalism

The Commission made 11 recommendations:

• First presentation of illness and discussion with the patient of any treatment plan is the clear responsibility of a generalist health care professional.
• Commissioning of health care should take full account of the need for continuity of care, 24 hours a day and 7 days a week, whatever the setting.
• New models of care need to be developed for patients in the community who live with episodic or deteriorating conditions.
• Generalists need to make more and better use of new information and communication technologies to improve communication.
• To speed and improve communication among doctors, GPs and hospital consultants should liaise directly and personally.
• Reward systems for institutions should promote the concept of generalism.
• Generalists should incorporate dynamic and on-going patient feedback into their work as a matter of routine.
• Medical training needs to become much more generalist in content, with more of it taking place in primary care settings.
• Care homes should have dedicated GPs responsible for provision of medical services to their residents.
• Greater investment is needed in academic general practice.
• The Academy of Medical Royal Colleges should invite its constituent bodies to examine the Commission's definition of generalism and incorporate the principles of generalist practice into postgraduate medical curricula.